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EBRI: Workers less interested in health plan out-of-pocket costs

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U.S. workers may be more interested than they used to be in sticking with traditional group health benefits, and they seem to be thinking more about their share of the premium cost than about either out-of-pocket costs or provider network quality.

Paul Fronstin, an analyst at the Employee Benefit Research Institute (EBRI), and Ruth Helman, an analyst at Greenwald & Associations, have published data supporting that possibility in a report distributed by EBRI.

The analysts used data from a telephone survey of 1,500 U.S. workers ages 21 to 64 that was conducted in mid-2015.  

The analysts found that the overall percentage of participants with employment-based health coverage who said they were satisfied with their health benefits fell to 66 percent in 2015, from 69 percent in 2014, and from 74 percent in 2012 and 2013.

But the percentage who said they would prefer to shop for coverage directly from an insurer fell to 16 percent, from 20 percent in 2014, and from 22 percent in 2012 and 2013.

The percentage who said they would like to take the money their employer now spends on health insurance and use it to buy health coverage themselves, or for other purposes, fell to 17 percent, from 19 percent in 2014, and from 21 percent in 2013.

The participants seemed to be more likely to think that their employers were spending too much money on unnecessarily rich benefits than that their employers were providing skimpy benefits. 

Some health policy analysts have worried that Patient Protection and Affordable Care Act (PPACA) coverage rules and economic pressure might have driven deductibles, co-payments and annual out-of-pocket maximum payment levels too high for enrollees to bear.

See also: Underinsurance may drive up hospital costs

But the percentage of participants who said they wish they could switch to an employer-provided plan that was less costly increased to 29 percent, from 26 percent. 

When the survey team asked participants about the impact of various factors that might affect their choice of health plans, 79 percent cited premiums as a major factor, down from 82 percent in 2014.

The percentage participants who cited a number of other factors typically associated with plan quality fell sharply.

The percentage who said deductible and copayments are a major factor fell to 76 percent, from 82 percent.

Similarly, the percentage who listed the annual limit on out-of-pocket expense dropped to 61 percent, from 71 percent.

The EBRI analysts have also provided ammunition for defenders of narrow provider networkers.

The percentage of workers who cited provider networks as a major plan selection factor fell to 53 percent, from 60 percent. The only factor that ranked lower than the provider network in 2015 was independent quality measures. Just 24 percent of the survey participants viewed independent quality measures as a major plan selection factor. 

Passion for plan choice may also be cooling. Eighty percent of workers said choice was very or extremely important, down from 82 percent in 2014. The percentage who was choice was somewhat or very important increased, but the percentage who said choice was extremely important fell to 41 percent, from 46 percent.

See also:

EBRI: High deductibles make patients talk

Survey: Drug benefits ‘skin in game’ varies widely


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